Tooth extraction, also known as exodontia, is the process of pulling out a tooth from its socket in the bone. For the good of your dental health, Dr. Klemann may recommend a tooth extraction if the tooth is broken or damaged by decay and cannot be saved with a filling, crown, or other dental treatment. In an emergency situation, Dr. Klemann will extract a tooth if it is due to severe tooth infection and pain.
Dr. Klemann may also recommend a tooth extraction under the following circumstances:
Compromised immune system. If your immune system is compromised (after receiving chemotherapy or having an organ transplant), the risk of infection in a particular tooth may be reason enough to pull the tooth.
Crowding. If your teeth are crowded, sound teeth may be extracted to create space so the rest of the teeth can be straightened. Similarly, if a tooth cannot break through the gum (erupt) because there is no room in the mouth for it, Dr. Klemann may recommend pulling it. This crowding may be due to a malposed tooth or supernumerary teeth (hyperdontia). A malpositioned tooth is one that has grown in a faulty position, whereas supernumerary teeth refer to a condition where there are more teeth present in the oral cavity than the normal number.
Impacted tooth/infection. An impacted tooth, such as a wisdom tooth (the third and final set of molars that most people get in their late teens or early twenties), sometimes gets stuck and cannot grow normally in the mouth. This may cause recurrent infections of the gum tissue around wisdom teeth (pericoronitis).
Periodontitis/Gum Disease. People with unhealthy gums that start receding and forming pockets are at risk for bacterial growth. Bacteria can seep inside the gums and cause an infection, leading to the decay of gums and even the tooth. The gums can become so weak that the base for tooth attachment can become fragile, and the tooth can fall out or must be pulled.
Trauma. Tooth extraction is recommended for patients who have fractured their jaw in an accident where the teeth are directly involved in the line of fracture.
Traumatic avulsion of a tooth is the complete displacement of the tooth from its socket due to the fracture of the alveolar bone, while intrusion is the displacement of the tooth into the alveolar bone. These conditions may require an extraction.
Tooth decay can damage a tooth when it extends to the pulp (the center of the tooth containing nerves and blood vessels). When this happens, bacteria in the mouth can enter the pulp and cause an infection. Usually, this can be corrected with root canal therapy, but when an infection is so bad that not even antibiotic treatment can cure it, Dr. Klemann will have to pull your tooth to prevent the spread of infection.
Although tooth extraction is a safe procedure, patients with certain medical conditions are at higher risk for developing a severe infection because the procedure can allow harmful bacteria into the bloodstream. Gum tissue is also at risk of infection. Therefore, you need to go over your medical and dental history (as well as any medications or supplements you might be taking) with Dr. Klemann before you have a tooth extraction. You should also let her know if you have any of the following medical conditions:
If you have any of these conditions, Dr. Klemann may have you take antibiotics before and after the extraction to lower your risk of infection.
A tooth extraction procedure starts with a local anesthetic to numb the affected area where the tooth will be removed. For a simple extraction where the tooth can be seen in the mouth, Dr. Klemann will loosen the tooth with an instrument called an elevator and will then remove it with forceps. If you have a broken or impacted tooth, Dr. Klemann will need to do a surgical extraction, cutting away gum and bone tissue that covers the tooth and using forceps to grasp the tooth to gently rock it back and forth to loosen it from the jaw bone and ligaments that hold it in place.
Once the tooth has been removed, a blood clot forms in the socket. Gauze is then packed on top of the socket, and the patient is instructed to bite down on it to help stop the bleeding. In some instances, stitches may be required to stop the bleeding.
Dry socket is a painful dental condition that sometimes happens after you have a permanent tooth removed. After the procedure, the blood clot in the socket fails to develop, or it dislodges or dissolves before the wound has healed. If this happens, underlying bone and nerves are exposed, resulting in intense pain.
Patients can get dry socket within 2 to 4 days after tooth extraction. The signs and symptoms of dry socket may include:
If you think you have developed a dry socket, call our office to schedule an emergency follow-up appointment. Dr. Klemann will likely place a sedative dressing over the socket for a few days to protect it while a new clot forms.
Possible side effects after tooth extraction may include
After tooth extraction, it may take 3-4 weeks for the soft tissue within the extraction site to heal fully. Following the procedure, Dr. Klemann will provide you with aftercare instructions, which may include:
If you are having a dental emergency that may require tooth extraction, call Distinctive Dentistry at (503) 698-4884 to schedule an appointment.
